etabolic syndrome is a cluster of metabolic abnormalities related to an increased risk of cardiovascular disease, 1 and recent research has demonstrated that adipocytokines, especially adiponectin, are associated with metabolic syndrome. 2 In terms of the evaluation and management of hypercholesterolemia (a risk factor of cardiovascular disease and a causative factor of death in more than 40% of heart-related deaths) according to the recommendations of the 2001 Third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Guidelines, the risk factors for the development of metabolic syndrome are visceral obesity, hypertension, hypertriglyceridemia, a low level of high-density lipoprotein cholesterolemia, and an impaired glucose tolerance. 3 Hyperuricemia is also considered by some investigators to be a component of metabolic syndrome that reflects insulin resistance. 4,5 In several epidemiological studies, a close relationship between hyperuricemia and hypertension, heart failure and other cardiovascular diseases has been reported, [6][7][8][9] and correlations between hyperuricemia and obesity, dyslipidemia, and diabetes have also been recently reported. [10][11][12] However, studies of Asians, who differ physically from Caucasians, are relatively rare. In Korea, knowledge of the general adult population without type 2 diabetes, hypertension and other diseases is inadequate, and no study has been performed on the association between the newly defined metabolic syndrome and hyperuricemia in the Korean population. Hence, this study investigated Korean adults who had undergone health screening to assess the correlation between increased serum uric acid concentration and hypertension, insulin resistance, and other risk factors of metabolic syndrome. Methods Study PopulationThe study group comprised 53,477 individuals (34,169 males, 19,308 females), who underwent health screening at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea between January 1, 2002, and December 31, 2002. Subjects who were taking diuretics, antihypertensive or antidiabetic agents, lipid-lowering agents, hyper-or hypouricemic agents, and those with any clinical suspicion of malignancy, acute infectious disease, acute inflammatory disease or renal disease were excluded. Physical Examination and Blood Pressure (BP)Height, weight, waist -hip circumference and systolic and diastolic BP were measured. According to the Hypertension Detection and Follow-up Program protocol, 13 BP was measured using a sphygmomanometer after the subjects had rested for more than 5 min. For those with a systolic BP >140 mmHg and a diastolic BP >90 mmHg (defined as hypertension by the 2003 JNC-7 14 ) BP was measured on a further 2 occasions after resting, and average Seung Ho Ryu, MD*; Dong Geuk Keum, MD** Background Associations between hyperuricemia, cardiovascular diseases and diabetes have been reported, but few of the studies have been conducted in the Korean population. The present study examined ...

ObjectiveWe developed a Korean version of Mini-Mental Status Examination (MMSE) optimized for screening dementia (MMSE-DS) and its' short form (SMMSE-DS).MethodsWe constructed the MMSE-DS using the items of the two current Korean versions of MMSE and then construct the SMMSE-DS consisted of 13 items from the MMSE-DS based on the diagnostic accuracy of individual items for dementia. We investigated reliability and validity of MMSE-DS and SMMSE-DS on 1,555 subjects (1,222 nondemented controls, 333 dementia patients). We compared the diagnostic accuracy of the SMMSE-DS with that of the three full Korean versions of MMSE, and examined its' age- and education-specific optimal cutoff scores for dementia.ResultsThe internal consistency obtained by Cronbach's coefficient alpha was 0.826. The inter-rater reliability and test-retest reliability were 0.968 (p<0.001) and 0.825 (p<0.001), respectively. It showed significant correlation with the Clinical Dementia Rating (CDR) (r=-0.698, p<0.05) and the three full Korean versions of MMSE (r=0.839-0.938, p<0.001). The area under the receiver operator curve for dementia of the SMMSE-DS was larger than those of the three full Korean versions of MMSE (p<0.001). Age, education and gender explained 19.4% of the total variance of SMMSE-DS scores. The optimal cutoff scores for dementia of the SMMSE-DS were estimated differently by age and educational attainment of the subjects.ConclusionThe SMMSE-DS was found to be accurate, brief and portable instrument for screening dementia in Korean elders, and may be particularly useful for screening dementia in elderly populations with wide variation in educational levels.

We investigated the prevalence of dementia and mild cognitive impairment (MCI) and the factors associate with risk of dementia from a representative nationwide sample of Korean elders. 8,199 randomly-sampled Koreans aged 65 years or older were invited to participate in the Phase I screening assessment using Mini-Mental State Examination by door-to-door home visit, and 6,141 subjects (response rate = 74.9%) responded. Among them, 2,336 subjects were invited to participate in the Phase II diagnostic assessment for dementia and MCI, and 1,673 subjects responded (response rate = 71.6%). Diagnostic assessments were administered using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K) Clinical Assessment Battery. The CERAD-K Neuropsychological Assessment Battery was used for diagnosing MCI. Age-, gender-, education-, and urbanicity-standardized prevalence of dementia was estimated to be 8.1% (95% CI = 6.9-9.2) for overall dementia and 24.1% (95% CI = 21.0-27.2) for MCI. Alzheimer's disease (AD) was the most prevalent type (5.7%) followed by vascular dementia (2.0%). Amnestic subtype (20.1%) was much more prevalent than nonamnestic subtype in MCI (4.0%). Older age, being male, lower education level, illiteracy, smoking, and histories of head trauma or depression were associated with increased dementia risk, and alcohol use and moderately intense exercise were associated with decreased dementia risk. We expect numbers of dementia patients to double every 20 years until 2050 in Korea and expect AD to account for progressively more dementia cases in the future.

ObjectiveDue to an unprecedented rate of population aging, South Korea is facing a dementia epidemic. For this reason, the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) was launched in 2009 with support from the Korean Health Industry Development Institute to investigate the epidemiology, biopsychosocial risk factors, and outcomes of dementia and dementia-related conditions. MethodsThe KLOSCAD is the first nationwide multi-center population-based prospective cohort study. In October 2010, 12,694 individuals were randomly sampled from residents aged 60 years or older who lived in 13 districts across South Korea. In the baseline assessment, which was conducted from November 2010 through October 2012, 6,818 (53.7%) individuals participated. Follow-up assessments have been conducted every two years, with the first follow-up assessment conducted between November 2012 and October 2014, and the second between November 2014 and October 2016. The third is now in progress, and will span from November 2016 to October 2018. Diagnosis of cognitive disorders, neuropsychological battery, behavioral and psychological symptoms of dementia, activities of daily living, physical and neurologic examination and laboratory tests, life styles, quality of life, and identification of death were evaluated in each assessment. ResultsThe cumulative drop-out rate at the second follow-up assessment was 38.7%. Dementia and mild cognitive impairment were 5.0% and 27.0%, respectively. ConclusionThe KLOSCAD may provide strong scientific evidence for advancing the fight against dementia both in Korea and globally.